乳腺手术患者围术期抗菌药物应用调查  

Application of antibiotics during perioperative period of breast surgery

作　　者：周艳华[1,2] 欧阳立志 曹丽芝[1,4] 伍俊玲 

机构地区：[1]湖南省肿瘤医院 [2]中南大学湘雅医学院附属肿瘤医院院感科,湖南长沙410013 [3]中南大学湘雅医学院附属肿瘤医院乳腺外一科,湖南长沙410013 [4]中南大学湘雅医学院附属肿瘤医院药学部,湖南长沙410013

出　　处：《中华医院感染学杂志》2013年第12期2970-2972,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解乳腺手术患者围术期预防使用抗菌药物的情况,为加强围手术期抗菌药物的合理使用和规范管理提供依据。方法对2011年5月-2012年3月875例乳腺手术及围手术期预防性使用抗菌药物的合理性进行评价。结果 875例乳腺手术患者围手术持续时间30～210min,>3h占8.68%、2～3h占26.63%,1～2h占45.03%、<1h的为19.66%,有1例发生切口感染;术期预防应用抗菌药物158例,使用率为18.00%,其中18例无抗菌药物使用指征占11.39%、术前30min～2h用药123例占77.85%、术前未用术后当日用15例占9.49%、术前>2h的13例占8.23%、术中7例占4.43%、术后用药>48h的6例;使用一代头孢菌素102例占64.56%。结论抗菌药物的管理措施及医院实施单病种临床路径可行、有效,能促进抗菌药物安全、合理、有效地使用。OBJECTIVE To investigate the status of use of antibiotics during perioperative period of breast surgery so as to provide basis for the reasonable use and standard management of antibiotics during the perioperative period. METHODS A total of 875 cases of patients who underwent the breast surgery from May 2011 to Mar 2012 were enrolled in the study , and the rationality of the use of antibiotics during the perioperative period was evaluated. RESULTS Of 875 cases of patients who underwent the breast surgery, the patients with the periopera- tive period from 30 to 210 rain and more than 3 hours accounted for 8.68%, the patients with the perioperative period of 2 3 hours 26. 63%, the patients with the perioperative period of 1-2 hours 45.03%, and the patients with the perioperative period less than 1 hour 19.66%, there was one case with incision infection. There were 158 cases of prophylactic use of antibiotics with the utilization rate of 18.00 %, among which there were 18 （11.39 % ） cases of patients without antibiotics use indications; there were 123 （77.85 % ） cases of patients who used antibiot- ics 30 rain-2 hours before the surgery, 15 （9.49%） cases of patients who did nor use before the surgery but used on the surgery day, 13 （8.23%） cases of patients who used antibiotics more than 2 hours before the surgery, 7 （4.43%） cases of patients who used antibiotics during the surgery, and 6 cases of patients who used antibiotics more than 48 hours after the surgery; there were 102 （64.56 %） cases of patients who used the first generation of cephalosporins. CONCLUSION It is practicable and effective to reasonably use antibiotics and carry out the single disease clinical pathway so as to promote the safe, reasonable, and effective use of antibiotics.

关 键 词：乳腺手术 围手术期 预防用药 抗菌药物 

分 类 号：R978.1[医药卫生—药品]